Whole-Brain Proton MR Spectroscopic Imaging of Mild-to-Moderate Traumatic Brain Injury and Correlation with Neuropsychological Deficits

• Published in: Journal of neurotrauma Vol. 27; no. 3; pp. 483 - 496
• Main Authors: Govind, Varan, Gold, Stuart, Kaliannan, Krithica, Saigal, Gaurav, Falcone, Steven, Arheart, Kristopher L., Harris, Leo, Jagid, Jonathan, Maudsley, Andrew A.
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc 01.03.2010
• Subjects: Adolescent; Adult; Aspartic Acid - analogs & derivatives; Aspartic Acid - analysis; Aspartic Acid - metabolism; Biomarkers - analysis; Biomarkers - metabolism; Brain; Brain - metabolism; Brain - pathology; Brain - physiopathology; Brain damage; Brain Injuries - metabolism; Brain Injuries - pathology; Brain Injuries - physiopathology; Choline - analysis; Choline - metabolism; Cognition Disorders - metabolism; Cognition Disorders - pathology; Cognition Disorders - physiopathology; Correlation (Statistics); Creatine - analysis; Creatine - metabolism; Diffuse Axonal Injury - metabolism; Diffuse Axonal Injury - pathology; Diffuse Axonal Injury - physiopathology; Disability Evaluation; Female; Frontal Lobe - metabolism; Frontal Lobe - pathology; Frontal Lobe - physiopathology; Glasgow Coma Scale; Humans; Injuries; Magnetic resonance imaging; Magnetic Resonance Spectroscopy - methods; Male; Measurement; Methods; Nerve Fibers, Myelinated - metabolism; Nerve Fibers, Myelinated - pathology; Neuropsychological Tests; Neuropsychology; NMR; Nuclear magnetic resonance; Original; Protons; Trauma; Wallerian Degeneration - metabolism; Wallerian Degeneration - pathology; Wallerian Degeneration - physiopathology; Young Adult; United States
• ISSN: 0897-7151; 1557-9042; 1557-9042
• DOI: 10.1089/neu.2009.1159

Changes in the distribution of the magnetic resonance (MR)-observable brain metabolites N-acetyl aspartate (NAA), total choline (Cho), and total creatine (Cre), following mild-to-moderate closed-head traumatic brain injury (mTBI) were evaluated using volumetric proton MR spectroscopic imaging (MRSI). Studies were carried out during the subacute time period following injury, and associations of metabolite indices with neuropsychological test (NPT) results were evaluated. Twenty-nine subjects with mTBI and Glasgow Coma Scale (GCS) scores of 10-15 were included. Differences in individual metabolite and metabolite ratio distributions relative to those of age-matched control subjects were evaluated, as well as analyses by hemispheric lobes and tissue types. Primary findings included a widespread decrease of NAA and NAA/Cre, and increases of Cho and Cho/NAA, within all lobes of the TBI subject group, and with the largest differences seen in white matter. Examination of the association between all of the metabolite measures and the NPT scores found the strongest negative correlations to occur in the frontal lobe and for Cho/NAA. No significant correlations were found between any of the MRSI or NPT measures and the GCS. These results demonstrate that significant and widespread alterations of brain metabolites occur as a result of mild-to-moderate TBI, and that these measures correlate with measures of cognitive performance.